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H Raemy

Publications and source records attributed to H Raemy.

8 recordsLinked to original sources
PubMed1986

[Long-term results of endoprosthetic joint replacement and synovectomy].

The operations most frequently performed for chronic polyarthritis are synovectomy and artificial joint replacement. The radioisotope synovectomy has in general reduced the need for operative synovectomy. Multicenter studies of the late results of operative synovectomy (over 10 years after the operation) show a lasting improvement in pain, although radiographically the destructive changes that are seen 10 years after the operation are similar to the non-operated side. The synovectomy can therefore buy important time since re-operation, e.g. arthroplasty, is performed mainly on clinical grounds and not on the roentgenographic appearance. Operative synovectomy (Larsen 0-2) is indicated when the radioisotope synovectomy fails. It should be performed as soon as possible. Primary operative synovectomy is mainly advised when mechanical factors are predominant (tenosynovitis, large masses of fibrin in a joint etc.) and where a denervation effect is produced at the same time (e.g. in the wrist). The remainder of this report concerns the multiplicity of problems with the various wrist- and finger joint-arthroplasties. Cemented prostheses and those with a fixed axis have been shown in the world literature to have a high need for re-operation because of loosening and secondary deformities of the fingers. The silastic spacer is more adaptable but is not without problems. This is particularly seen with constitutional or cortisone-induced ligamentous laxity where bone resorption due to the piston effect and abrasion becomes evident together with sinking and often breakage of the prosthesis. The attempts made to prevent this are reported. The improvement in function from the MP-arthroplasty is very dependent upon the condition of the PIP-joints and the thumb. The significance of this with respect to the operative indication is discussed. Although the PIP-arthroplasty can initially have a good range of motion, a reduction after a number of years can be seen because of periprosthetic fibrosis. In general, when the operative indication is correctly made and with good postoperative management, arthroplasty can give good long-term results. The carpometacarpal joint of the thumb is relatively seldom involved in polyarthritis and the main indication for arthroplasty is osteoarthritis. The extent of trapezium resection and the various types of prostheses are discussed. The authors warn against treating a single joint in isolation without considering the other joints which work together with it in a functional chain.

Adolescent↗
PubMed1986

[Long-term results after the surgical treatment of saddle joint arthrosis with Swanson's silastic prosthesis].

The use of a silastic implant in resection arthroplasty of the carpometacarpal joint of the thumb allows the joint space to be preserved. With the Swanson type arthroplasty relief of pain, good function, as well as stability and improved pinch force can be obtained, avoiding the consequence of carpal instability by narrowing of the joint space associated with resection of the trapezium alone or in combination with tendon interposition arthroplasty. The two main problems associated with Swanson arthroplasty are prosthetic dislocation and longterm stability of the prosthesis itself. The joint surface of the prosthesis wears out asymmetrically, and mild to severe foreign body reactions can be seen in the carpal bones, mainly the scaphoid. Clinical and radiological results of a series of 77 operations in 65 patients from 1975-1981 are presented and discussed.

Adult↗
PubMed1986

[Functional treatment of fresh outer ligament ruptures using an Aircast splint].

Functional treatment with an Aircast splint can reduce pathological inversion of the ankle joint. Now that we have used the splint since 1981, we report our experience with a small group of patient who have been reviewed three times in the last 4 years. The patients reported good-to-excellent results. Objective evaluation was slightly better in the first follow up evaluation with increased laxness in the stress tests in the last control. However only one patient needed ligament reconstruction. The Aircast splint provides good-to-excellent subjective results and good objective results in 75% of cases. The following indications are valid for operative treatment: Laxity with a talar tilt of definitely more than 15 degrees, or with an anterior drawer of the talus of more than 12 mm in a young athlete who is dependent on complete stability. Patients with osteochondral lesions and avulsed fibular fragments. History of pre-existing recurrent subluxations, possibly in combination with a ligament reconstruction.

Adolescent↗
PubMed1980

[Functional treatment of humerus fractures by Sarmiento's method].

We treated 14 cases of fracture of the shaft of the humerus with the functional method published by A. SARMIENTO in 1977, consisting of a plastic sleeve and early introduction of functional activity. The results were excellent, healing time and restoration of motion have been rapid.

Adult↗